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BackgroundViolence against children (VAC) is a serious public health concern with long-lasting adverse effects. Evidence-based parenting programs are one effective means to prevent VAC; however, these interventions are not scalable in their typical in-person group format, especially in low- and middle-income countries where the need is greatest. While digital delivery, including via chatbots, offers a scalable and cost-effective means to scale up parenting programs within these settings, it is crucial to understand the key pillars of user engagement to ensure their effective implementation. ObjectiveThis study aims to investigate the most effective and cost-effective combination of external components to optimize user engagement with ParentText, an open-source chatbot-led parenting intervention to prevent VAC in Mpumalanga, South Africa. MethodsThis study will use a mixed methods design incorporating a 2 × 2 factorial cluster-randomized controlled trial and qualitative interviews. Parents of adolescent girls (32 clusters, 120 participants [60 parents and 60 girls aged 10 to 17 years] per cluster; N=3840 total participants) will be recruited from the Ehlanzeni and Nkangala districts of Mpumalanga. Clusters will be randomly assigned to receive 1 of the 4 engagement packages that include ParentText alone or combined with in-person sessions and a facilitated WhatsApp support group. Quantitative data collected will include pretest-posttest parent- and adolescent-reported surveys, facilitator-reported implementation data, and digitally tracked engagement data. Qualitative data will be collected from parents and facilitators through in-person or over-the-phone individual semistructured interviews and used to expand the interpretation and understanding of the quantitative findings. ResultsRecruitment and data collection started in August 2023 and were finalized in November 2023. The total number of participants enrolled in the study is 1009, with 744 caregivers having completed onboarding to the chatbot-led intervention. Female participants represent 92.96% (938/1009) of the sample population, whereas male participants represent 7.03% (71/1009). The average participant age is 43 (SD 9) years. ConclusionsThe ParentText Optimisation Trial is the first study to rigorously test engagement with a chatbot-led parenting intervention in a low- or middle-income country. The results of this study will inform the final selection of external delivery components to support engagement with ParentText in preparation for further evaluation in a randomized controlled trial in 2024. Trial RegistrationOpen Science Framework (OSF); https://doi.org/10.17605/OSF.IO/WFXNE International Registered Report Identifier (IRRID)DERR1-10.2196/52145

Abstract Background Intimate partner violence (IPV) is a serious public health issue which experienced a sharp incline during the onset of COVID-19. Increases in other forms of violence, such as violence against children (VAC), have also been linked to the pandemic, and there have been calls for greater prevention efforts that tackle both forms of violence concurrently. The COVID-19 crisis has highlighted the urgent need for evidence-based and scalable violence prevention interventions that target multiple forms of family violence. Parenting programmes have shown promising results in preventing various forms of family violence, including IPV and VAC, and have recently experienced an expansion in delivery, with digital intervention formats growing. This paper describes the development and evaluation of the IPV prevention content designed and integrated into ParentText, a chatbot parenting intervention adapted from Parenting for Lifelong Health programmes. Methods The ParentText IPV prevention content was developed using the Six Steps in Quality Intervention Development (6SQuID) framework. This involved targeted literature searches for key studies to identify causal factors associated with IPV and determining those with greatest scope for change. Findings were used to develop the intervention content and theory of change. Consultations were held with academic researchers (n = 5), practitioners (n = 5), and local community organisations (n = 7), who reviewed the content. A formative evaluation was conducted with parents in relationships (n = 96) in Jamaica to better understand patterns in user engagement with the intervention and identify strategies to further improve engagement. Results Using the 6SQuID model, five topics on IPV prevention were integrated into the ParentText chatbot. Text-messages covering each topic, including additional materials such as cartoons and videos, were also developed. The formative evaluation revealed an average user-engagement length of 14 days, 0.50 chatbot interactions per day, and over half of participants selected to view additional relationship content. Conclusions This article provides a unique contribution as the first to integrate IPV prevention content into a remotely delivered, digital parenting intervention for low-resource settings. The findings from this research and formative evaluation shed light on the promising potential of chatbots as scalable and accessible forms of violence prevention, targeting multiple types of family violence.

Contexto e Objetivo: Estudos recentes mostram um aumento de ideação e comportamentos suicidas entre jovens, havendo fortes associações com ser pobre, ser mulher, ser LGBT (lésbica, gay, bissexual ou transgénero) e sofrer discriminação na escola e/ou na internet. Embora os determinantes sociais da ideação suicida sejam amplamente debatidos em todo o mundo, há uma lacuna sobre esses temas em relação aos jovens brasileiros, o que o presente estudo pretende contribuir para preencher. Métodos: O estudo transversal utilizou uma amostra de conveniência de 475 alunos do ensino médio (16–17 anos) de nove escolas públicas do estado de São Paulo, Brasil. Resultados: Do total de entrevistados, 224 deles relataram ideação suicida ao longo da vida, uma prevalência inesperadamente alta (47,2%). Na análise múltipla com estimativa da razão de prevalência (RP) ajustada, atração por pessoas do mesmo sexo ou bissexual (RP = 1,87; IC95%: 1,5–2,3), estudar em escolas noturnas (RP = 1,36; IC95%: 1,1–1,6) — indicativo de menor condição econômica — e ser discriminado em escola (RP = 1,22; IC95%: 1,0–1,5) e na internet (RP = 1,48; IC95%: 1,2–1,8) foram associados positivamente à ideação suicida ao longo da vida. Raça/etnia e gênero dos alunos não foram associados. Conclusões: Os resultados apontam para a necessidade de consideração dos determinantes sociais da saúde mental no debate público e nos programas de intervenção voltados à juventude no Brasil e em outros lugares. O aprimoramento da promoção da saúde mental, levando-se em conta os determinantes sociopolíticos da saúde, deve ser uma prioridade estratégica e política. É crucial uma perspectiva interseccional abrangente que reflita sobre as várias formas de dominação e como estas se conectam com o sofrimento mental e suas consequências.

Peer tutoring (PT), as a pedagogical technique, is a form of collaborative learning that consists in a student (tutor) teaching a certain knowledge to a peer (tutee). Widely studied within the literature, it has been implemented in different contexts and educational levels. However, little is known about the multiple application methods of PT, which vary according to each educational situation. Therefore, using a documentary method, a meticulous description of the PT implementation variables and their numerous variants is presented, using the classification presented by Topping (2015) and Leung (2015) as a guide. In addition, new variables previously not considered are proposed. For this purpose, 26 empirical studies of PT were thoroughly selected and analyzed. All the articles were focused exclusively on developing academic skills, reading, writing and mathematics, and took place in different educational levels, primary, secondary and higher education. Furthermore, a first approach to the analysis of the most predominant PT implementation variables in each educational level and academic ability is presented. The article concludes with its scopes and limitations, proposing new research horizons.

Objetives: Omega-3 (n3) fatty acids have been studied as an option to alleviate the harmful effects of obesity. However, its role in obesity-related behavioral changes is still controversial. This study aimed to evaluate the effects of n3 on behavior and neuroinflammation in obese animals. Methods: Male Wistar rats were divided into four groups: control diet (CT), CT+n3, cafeteria diet (CAF), and CAF+n3. Diet was administered for 13 weeks, and n3 was supplemented during the last 5 weeks. Metabolic and biochemical parameters were evaluated, as well as anxiety-like behaviors. Immunoblots were conducted in the animals' cerebral cortex and hippocampus to assess changes in neuroinflammatory markers. Results: CAF-fed animals showed higher weight gain, visceral adiposity, fasting glucose, total cholesterol, triglycerides, and insulin levels, and n3 improved the lipid profile and restored insulin sensitivity. CAF-fed rats showed anxiety-like behaviors in the open field and light–dark box tasks but not in the contextual aversive conditioning. Omega-3 did not exert any effect on these behaviors. Regarding neuroinflammation, diet and supplementation acted in a region-specific manner. In the hippocampus, CAF reduced claudin-5 expression with no effect of n3, indicating a brain–blood barrier disruption following CAF. Furthermore, in the hippocampus, the glial fibrillary acidic protein (GFAP) and toll-like receptor 4 (TLR-4) were reduced in treated obese animals. However, n3 could not reverse the TLR-4 expression increase in the cerebral cortex. Discussion: Although n3 may protect against some neuroinflammatory manifestations in the hippocampus, it does not seem sufficient to reverse the increase in anxiolytic manifestations caused by CAF. [ABSTRACT FROM AUTHOR]

Introducción: la duración ideal de la asistencia ventilatoria mecánica (AVM) genera debate e incertidumbre. El intento de desvinculación prematuro condiciona fracaso y aumento de mortalidad, mientras que la desvinculación tardía aumenta el riesgo del paciente. La utilización de pruebas de ventilación espontánea (PVE) son seguras e identifican aceptablemente a los pacientes listos para desvinculación. Sin embargo, la adherencia a pautas protocolizadas es muy variable y falla la implementación de evidencia científica a nivel clínico. Objetivo: analizar la interacción entre pautas de desvinculación de AVM y evaluación médica para la toma de decisiones. Material y método: trabajo descriptivo, prospectivo, con entrevista a médicos en la unidad de cuidados intensivos (UCI) sobre su valoración de la condición del paciente para realizar una PVE. Se comparó la opinión del médico con la evaluación hecha según protocolo de la UCI. Se analizaron coincidencias y discrepancias entre opinión de médicos y protocolo. Resultados: ingresaron 27 pacientes y 46 médicos. Las coincidencias representaron el 85,4% de las opiniones aunque existieron elementos de “confusión” en la decisión médica, tanto en coincidencias como en discrepancias. El más frecuente fue el estado de conciencia del paciente. Discusión y conclusiones: la valoración de la conciencia es fundamental para la asistencia diaria, pero no para la PVE. Su inclusión se vio involucrada en casi un tercio de las respuestas obtenidas, difiriendo la realización de la PVE. Este aspecto debe ser tenido en cuenta tanto para instancias docentes como asistenciales al momento de optimizar los tiempos para PVE y desvinculación de la AVM.

La presente investigación tiene por finalidad explorar los tipos de actividades escolares registrados en la carpeta escolar y la percepción del esfuerzo asociado al rendimiento escolar, en jóvenes y adultos de nivel medio de escuela privada de adultos. Para conocer las actividades y el significado del esfuerzo se optó por la entrevista semiestructurada. La guía se organizó en base a dos ejes: uno acerca de la carpeta y otro acerca del esfuerzo escolar. Con el consentimiento de los alumnos adultos se grabaron las entrevistas y una vez transcriptas se procedió al análisis por párrafos con el Método Comparativo Constante. Para identificar los tipos de actividades realizadas en la carpeta se construyó un protocolo de registro basado en los siguientes criterios: la organización y aspectos formales de la carpeta, y tipos de actividades y diseño didáctico. Para su análisis se optó por el método de análisis documental. La muestra fue no probabilística de tipo intencional por conveniencia, constituida por 15 jóvenes y adultos de la Escuela Secundaria de Jóvenes y Adultos. Del análisis de las entrevistas se obtuvieron los siguientes significados: el esfuerzo como respuesta al modelo de alumno esperable y el esfuerzo asociado al rendimiento escolar. En cuanto a las actividades se constata la prevalencia del tipo acumulativo o de copia para fijar conocimientos que carecen de contextualización, siendo los contenidos de poca significatividad psicológica; además son escasas las actividades de producción individual. Se concluye que el esfuerzo es una condición necesaria para acceder al modelo o patrón de alumno esperable en las escuelas secundarias de adultos y suficiente para el aprendizaje escolar basado en la repetición.

En el presente artículo se presentan los resultados parciales acerca de la exploración de los significados atribuidos al aprendizaje escolar de jóvenes y adultos (n17) de una escuela media de adultos del barrio de la zona sur de la Ciudad de Buenos Aires. Los mismos se obtuvieron por entrevistas semiestructurada y fueron analizadas por método comparativo constante. Se construyeron veintiún códigos y cinco categorías: el aprendizaje como promotor del saber y del ser alguien requiere de esfuerzo y motivación. Se identifican factores subjetivos y sociales que dificultan el proceso, así como también redes de ayuda que facilitan el aprendizaje. Las categorías emergentes constituyeron la base del diseño de la encuesta cuyas preguntas abiertas y cerradas fueron tomadas a docentes y no docentes de la modalidad (n73). En el análisis de las preguntas abiertas se identificaron dos tipos de miradas acerca de los sujetos de aprendizaje: quienes consideran a los jóvenes y adultos como sujetos pasivos, víctimas de las situaciones familiares, escolares y económicas y otra que los considera como sujetos activos, actores de su propia vida y constructores de otros futuros posibles. Se concluye que las miradas de los docentes y no docentes ejercen una influencia simbólica significativa y son predictores de futuro para los sujetos de la modalidad. Esta polarización de miradas reclama un trabajo de explicitación y revisión de prácticas profesionales.

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